DR. AYANTIKA DAS

Dr.SANTOSH MAHAPATRA, DR.PRAMOD KUMAR SHARMA

Abstract

A hypertensive medico in late 20s presented with sudden bilateral diminution of vision for few days. His anterior segment was within normal limits without any significalnt systemic findings. Dilated fundus examination revealed inflammatory disc edema, marked venous dilatation and tortuosity, perivascular sheathing, retinal haemorrhages, microaneurysm and cotton wool spots. Not being convinced about diagnosis of malignant hypertensive retinopathy or retinal vasculitis or IRVAN we ordered for Blood reports which showed mild anemia, leukocytosis and raised platelet count and ESR with negative Mantux. Peripheral blood smear and BMA revealed hypercellularity with proliferating myeloid cells. Diagnosed with CMLRP, patient was referred to Oncologist. Moral of the story – first appearance can be deceiving -hence investigate to reach at a diagnosis and best possible management.